Improving Rehabilitation Services through Payer Mobilization in Maine

This article discusses how payer mobilization can improve rehabilitation services in Maine. It highlights the importance of Medicare and Medicaid in financing strategies to enhance healthcare infrastructure. The article also provides a timeline for the implementation of the project and discusses the problem statement.

Running head: HEALTH CARE ECONOMICS 1
Health care economics
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Payers
The main focus of the rehabilitation project will be to effectively enhance the
availability and access of medications, Room, and boards, physical therapist, occupational
therapist, speech therapists, nurse services, supply and physiatrist visit through the use of
payers. The availability of such services and facilities will be critically significant in
addressing health challenges and improve on services such as stroke, physical and
occupational therapy, speech-language pathology, cardiac and stroke, brain injury and sports
medicine rehabilitation (Prybil, et al, 2016).
The project intends to engage public and private payers to help in financing strategies
aimed at improving infrastructure for health care services and investments in systems for
purposes of encouraging access to rehabilitation services to patients. Payers such as Medicare
and Medicaid will be attracted to the project. An estimated total of over $29 million dollars
will be mobilized within a period of three years to ease access to medications, room, and
boards, physical therapist, occupational therapist, speech therapist, nurse services, supply,
physiatrist visit in the area of Maine, United States of America(Prybil, et al, 2016). The above
finances will facilitate general improvements in health services; reduce the level of
unavoidable emergency departmental visits, patient admissions and coordination of care. It
should be noted that studies carried out from the area of MAINE, show that the overall
physical and occupational therapy, speech-language pathology, cardiac and stroke rehab,
brain injury and sports medicine rehabilitation services in a variety of inpatient and/or
outpatient settings have been poor (Prybil, et al, 2016). Therefore, the mobilization of
services from both private and Government payers like Medicare and Medicaid will help to
improve the level of patient access to such services. There have been funding issues in the
area of MAINE, the United States of America which can effectively be solved their

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mobilization of payers to acquire the necessary infrastructure that is significant towards the
increase service access to patients (United Health Foundation, 2016).
Individual payers will also supplement others payers for purposes of increasing the
number of resources needed in the rehabilitation project. Various models will be utilized
while mobilizing money meant for physical and occupational therapy, speech-language
pathology, cardiac and stroke rehab, brain injury and sports medicine rehabilitation services
in a variety of inpatient and/or outpatient settings (Prybil, et al, 2016).
The payer payment strategy will make it easier to obtain the necessary resources vital
for the project. The fund obtained from payers will mainly focus on addressing the
community needs of the physical and occupational therapy, speech-language pathology,
cardiac and stroke rehab, brain injury and sports medicine rehabilitation services in a variety
of inpatient and/or outpatient settings. Important to note is that the available strategies and
tactics have not been effective enough in addressing the current challenges of the patients
associated with the above conditions, Therefore, the mobilization of payers will enable
increased sensitization and access to health care services of the concerned population
throughout the area of Maine, United States of America (Prybil, et al, 2016). Increased
sensitization, infrastructure, and resources will make it easier to provide educational sessions,
guidance, and counseling to the different areas of MAINE that are badly in need of the
services (Buetti et al, 2017).
More so, the funds mobilized from payers will make it easier to recruit more staff to
increase the current staff capacity. With the increased in the medical practitioners in the
health setting in the area, there is no doubt that effective and efficient services will be
provided to all patients in the in and outpatient settings. It should be noted that one of the
challenges that have been affecting the health care system has been inadequate personnel to

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effectively handle the ever-increasing needs of the patients in an effective and efficient
manner (Lahtinen et al, 2017). Hence with the increase in the number of the physiatrists,
there is no doubt that challenges such as ligaments, spinal cord, and other related issues that
have been affecting patients will effectively be handled. Further, the availability of
medications will also improve in the health setting due to the prudent payer mobilization
strategies that will be implemented(Prybil, et al, 2016). With improved medication, patients
will be able to access the necessary medicine in an effective and efficient manner. The level
of motivation will be improved as more payers join the struggle to improve the level of
infrastructure and other health care services. Medical personnel like nurses, occupational
therapist, speech therapist and physical therapist will be plenty in supply and motivated due
to the available resources to fund their activities. Therefore, the major focus of the
rehabilitation project will be to work in conjunction with the payers, make rational and
prudent investments in the various healthcare delivery and service mechanisms mainly
physical and occupational therapy, speech-language pathology, cardiac and stroke rehab,
brain injury and sport medicine rehabilitation services in a variety of inpatient and/or
outpatient settings in the area of Maine USA(Prybil, et al, 2016).
Problem statement
As a result of increased number of people in Maine with a high rate of physical and
occupational therapy, speech-language pathology, cardiac and stroke, brain injury and sports
medicine rehabilitation services, there has been the need to reform the laws, policies, and
delivery of rehabilitation services (Buetti et al, 2017). According to the Health survey that
was done in Maine to evaluate the implementation of rehabilitation services indicate that 42%
of the population respond to rehabilitation and 48% failed to. Therefore, it is understood that
the rehabilitation services in MAINE have always been let down by lack of basic plans,
limited resources, infrastructure and also inadequate information regarding health. In the

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effort to solve the issues that are limiting rehabilitation of physical and occupational therapy,
speech-language pathology, cardiac and stroke, brain injury and sport, the Department of St
Joseph’s in MAINE has decided to provide a number of therapies and services. The
rehabilitation services are provided to both the Outpatients and inpatients of St Joseph's
medical centre. The services provided are basically focussed on helping patients recover from
physical and occupational therapy, speech-language pathology, cardiac and stroke and brain
injury. In addition, for those patients who do not need inpatient care or treatment, they are
provided with outpatient rehabilitation (Prybil, et al, 2016).
According to the Policy Academy State Profile, MAINE has a population size of 1.3
million people, of these, more than 500,000 are above 50 years and 300,000 people are over
60 years. In 2010, about 100,000 people were considered to have abused treatment and 70.7%
were men, 96.6% were whites and 1.6 were blacks. 700, 000 people in Maine suffer from
stroke every year and about two-thirds of the people survive and require taking for
rehabilitation (United Health Foundation, 2016).
Timeline
The implementation of the physical plant, and technology improvement, and staffing
will only take one year to complete it. The implementation of the tasks will be facilitated by
the SVH services of MAINE. The organization will be responsible for all the financial and
monitoring of the process. Therefore, for an effective implementation of the project in the
proposed timeline, a proper and clear plan must be laid down or formed. The plan should
include the marketing, and lobbying of finance from the MAINE central government so as to
have a quick response (Buetti et al, 2017). In addition, the plan needs to have a clear
explanation of any action that should be taken in case of a change. The implementation of the
physical plant will take 5 months, and infrastructure will take 2 months. For better technical

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improvement, fine and latest machines will be implemented so as to avoid downtime and
breakdown. To note, staffing will depend on the level of knowledge an individual has
towards a given service. The contract process of the project will be started earlier in the plan
so as to avoid any case of inconvenience later in the implementation stage. Therefore,
contractors will be required to make their applications within a period of one month before
the process begins. Because the task will be done by the state, strict rules and procedures will
need to be followed so as to ensure the proper implementation of the physical plant,
infrastructure, and technology improvement (United Health Foundation, 2016).

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References
Prybil, L., Connelly, M., Ferguson, D., Totten, M. (2016). The Leadership Role of Nonprofit
Health Systems in Improving Community Health. [PDF Report]. American Hospital
Association (Publisher). Retrieved from http://trustees.aha.org/ populationhealth/16-
leadership-role.pdf.
United Health Foundation. (2016). Health Measures in Maine [Dataset].Retrieved by Cowan,
T., using America’s Health Rankings from http://www.americashealthrankings.org.
Buetti, N., Atkinson, A., Kronenberg, A., Marschall, J., and Swiss Centre for Antibiotic
Resistance (ANALYSIS) Auckenthaler R. Cherkaoui A. Gaia V. Dubuis O. Egli A.
Koch D. Kronenberg A. Luyet S. Nordmann P. Perreten V. Piffaretti J.-C. Prod'hom
G. Schrenzel J. Leib S. Widmer AF Zanetti G. Zbinden R. (2017). Different
epidemiology of hospital-acquired bloodstream infections between small community
hospitals and large community hospitals. Clinical infectious diseases, 64(7), pp.984-
985.
Lahtinen, A., Leppilahti, J., Vähänikkilä, H., Harmainen, S., Koistinen, P., Rissanen, P. and
Jalovaara, P. (2017). Costs after hip fracture in independently living patients: a
randomized comparison of three rehabilitation modalities. Clinical
rehabilitation, 31(5), pp.672-685.

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